Volkmann ischemic contracture

Samuel O. Poore MD, PhD,, Michael L. Bentz MD, FAAP, FACS, in Plastic Surgery Secrets Plus (Second Edition), 2010 25What is Volkmann's ischemic contracture, what injury is most likely to cause it, and how is it treated? Volkmann's ischemic contracture is the result of unrecognized or inadequately treated compartment syndrome of the forearm, causing muscle ischemia, necrosis, and ultimately contracture of the hand (see Fig. 119-3). Skeletal trauma is the most likely cause of an acute compartment syndrome of the forearm. Although supracondylar fractures of the humerus are the most likely etiology of compartment syndrome, all patients with humerus and radial/ulnar fractures should be carefully monitored for vascular injury and compartment syndrome. Treatment is difficult and often multifaceted, including excision of fibrous tissue, neurolysis, tenolysis, capsulotomy, nerve grafting, and innervated free tissue transfer. Ludwig Ombregt MD, in A System of Orthopaedic Medicine (Third Edition), 2013 Special conditions Ischaemic contracture or adherence of the extensor hallucis longus The muscle may develop ischaemic contracture or become adherent after a fracture at mid-tibia. This results in a constant-length phenomenon. Each time the foot is plantiflexed, the shortened extensor hallucis muscle extends the big toe, which is forced against the tip of the shoe. This may result in extreme soreness of the big toe. The treatment is tenotomy level with the first metatarsophalangeal joi...

Clinical case: Volkmann’s ischemic contracture Author: Reviewer: Last reviewed: May 25, 2023 Reading time: 18 minutes Who's to say that the systems such as Volkmann's ischemic contracture will be very interesting. On the other hand, even though you're not such a fan of the muscles and bones, we bet that this clinical approach to Key Facts Common flexor tendon The tendon of origin for most of the flexor muscles of the wrist and digits that rises from the medial epicondyle of the humerus Common extensor tendon The tendon of origin for many of the extensor muscles of the wrist and digits that rises from the lateral epicondyle of the humerus Golf elbow Medial epicondyle pain, due to medial epicondylitis caused by the overuse (irritation, fibrosis or inflamation) of the common flexor tendon Tennis elbow Lateral epicondyle pain, due to lateral epicondylitis caused by overuse of the common extensor tendon Pronation & supination Pronation - medial rotation of the radius at the distal and proximal radioulnar joints, resulting in the palm of the hand facing posteriorly Supination - lateral rotation of the radius at the distal and proximal radioulnar joints, resulting in the palm of the hand facing anteriorly Long bone growth Ossification of the cartilaginous model via 3 processes: growth in length, growth in thickness, remodeling Compartment sydrome Sudden increase of pressure within a muscle compartment due to various insults; clinically there are 2 types: acute and chronic...

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A Volkmann ischaemic contracture refers to a complex and variable flexion deformity involving distal limbs (typically the wrist and fingers) resulting from fibrosis and contracture of flexor muscles. Fracture of hinge joint (elbow) or arm outcomes this contracture. It is associated with supracondylar fracture of the humerus classically 7. Article: • • • • Clinical presentation A number of deformities can occur. In the upper extremity, this includes elbow flexion, forearm pronation, wrist flexion, thumb flexion and adduction, digital metacarpophalangeal joint extension, and interphalangeal joint flexion. The affected limb may become dysfunctional, painful and may lose sensitivity. Pathology It is caused by ischaemic injury to the deep tissues enclosed in tight unyielding osteo-fascial compartments often secondary to neglected 7. Location • forearm and wrist: classically described sites • ankle and foot: uncommon 6 Treatment and prognosis Therapy depends upon on extent of contracture: • mild cases are treated with physical therapy, tendon lengthening and dynamic splinting • moderate contracture requires neurolysis and extensor tendon transfer surgeries • severe cases are dealt with by radical debridement of scar, followed by tendon transfer procedures 7 ​ • 1. L M, Kiran K K, Kc V, Prasad R S. Volkmann's Ischemic Contracture with Atrophic Non-Union of Ulna Managed by Bone Shortening and Transposition of Radial Autograft. J Orthop Case Rep. 2015;5(1):65-8. • 2. Lapuk S & Wood...

Neonatal compartment syndrome is a rare condition. Early diagnosis and timely surgical intervention are paramount to optimize outcome. Time to fasciotomy is the most important prognostic factor. The purposes of this study were to describe a case presentation of neonatal compartment syndrome associated with a compound birth presentation and to perform a literature review. In this case, the neonate’s fingers were noted to be present on maternal cervical examination 24 hours before delivery. The patient then was noted to have a sentinel skin lesion. A diagnosis of neonatal compartment syndrome was suspected, and she underwent urgent fasciotomy. Literature review identified a total of 60 patients from 26 studies. Most patients were managed operatively. All patients presented with a sentinel skin lesion, emphasizing the importance of this clinical sign in diagnosis. Manometry is not routinely performed and no standards are available for acceptable pressure gradients. • Previous article in issue • Next article in issue